Originally published on 17/11/21----------------------------------
On a Tuesday night in the Emergency Department of the Manchester Royal Infirmary, strangers mingle in each other’s sickness and despair. Some come from the office; others from a concert. They come from football matches and street fights. A few are fresh out of the pub. They form a line waiting for the triage. A nurse decides how serious their case is and sends them to the waiting room. Here they will spend the next hours of their lives in a torturous pantomime of chaos and misery. 
In the artificially lit waiting room, an apathetic receptionist takes the details of the new arrivals. Some have wheelchairs, others are perched on cheap plastic chairs or rough metal benches. A man on shaky legs arrives complaining of necrotic flesh in his hand. He sits next to an injured boy in a football kit. The boy’s mum is by his side, nervously fidgeting with her hijab. To their right is a tall young man in a tracksuit, speaking with a girl who had a McDonalds delivered to the waiting room. Next to them, a woman in a mobility chair awaits a bed for the night. A middle aged man with stitches in two fingers watches blood and puss seep through his bandages; he worries his fingers will need amputating. Beside him, a young man with heart problems winces from the pain in his arm where the nurses repeatedly failed to draw blood. The young man is told it will take five hours for a doctor to see him. There are only two doctors on call tonight despite the waiting room currently holding over thirty patients.
The waiting room stagnates. The waves of new arrivals slow. Those present haven’t seen much progress. Nurses call out names in a jagged manner; African and Asian names are brutally dissected into sterile syllables. Some wonder why they are forced to stay rather than go and come back when the doctor is ready, or be given their results over the phone. 
“We can’t be phoning people, we’re far too busy for that!” says one nurse when asked.
Evil vending machines take people’s money and give no snacks. The restrooms are filthy. There is a TV on the wall with only “PLEASE WAIT HERE” on show. Many have come prepared with books, food and blankets. Some are dressed in suits; others in nightgowns. A man with kidney stones clutches his side and moans. An old woman vomits into a bucket. It is cold. No one is comfortable. 
A nurse rolls a man in a wheelchair into the disabled toilets. She leaves. Minutes later, he knocks on the door for help. No one answers. The mother in the hijab tells the receptionist, who doesn’t seem to care. Eventually, the young man in the tracksuit gets up and wheels the old man out. Behind two squelching double doors, in the bowels of the hospital,  the sickest of people lay in rooms open for all to see. Steroid infused male nurses wander the halls in their navy-blue scrubs. A drunk boy drooling on himself is given a bed for the night; the lady in the mobility chair waits on. The squelching doors don’t disguise the sounds of screaming in the deep.
Two police officers escort a young man in handcuffs to the reception. He hurls abuse at any who makes eye contact. 
“What!?” he calls out to a girl. “You think I’m in custody or something? You think I won’t get out of here and bash your boyfriend’s head in?”
A nurse comes over to take him. 
“Flappy-arsed bitch!” he yells as they drag him through the double doors.
A moment of silence.
“I would never let my son turn out like that…” announces a woman in the crowd. 
“All these people in the waiting room, but the second you come in with police you go straight through…” mutters another. 
A nurse calls names and no one answers. Many go home unseen. Some fall asleep and miss their call. Others adopt a prison-like buddy system, taking turns to sleep. The Pavlovian conditioning sets in; every time the double doors squelch open, heads turn, hoping their name will be called. Despite the pain and loneliness, some make it through. A woman emerges from the double doors after seeing a doctor and leaves. On her way out, she thanks those she has formed kinship with in her time here and wishes them good luck. None of them are staff. 
The NHS is often praised by supporters of universal healthcare and attacked relentlessly by its critics. Data from the A&E Attendances and Emergency Admissions September 2021 Statistical Commentary, published on the NHS website, tells the tale. It outlines how A&E waiting times form part of the NHS Constitution. Operational standards dictate that 95% of patients should be admitted, transferred or discharged within 4 hours of their arrival at an A&E department. The September statistics reveal that 0 out of 112 reporting trusts achieved the 95% standard during the month. In fact, the 95% standard hasn’t been met since July 2015. In September, there were 105,000 four-hour delays, which compares to 64,900 in September 2019, the last recorded year pre-Covid-19 pandemic. Of these, 5,030 were delayed over twelve hours, which compares to 458 in September 2019. This is the highest number since the collection began. 
Nobody should have to undergo such conditions to access emergency help. Outrageous wait times, poor facilities, people herded like cattle with nothing to separate the minorly injured from the severely diseased. In a post-Covid environment, it may be time to rethink the UK’s healthcare system. Patients and staff deserve better. Although the staff here may once have been bright-eyed optimists, it seems as though they have grown cold and detached from the trauma that surrounds them. Overworked and underfunded, their need for self-preservation demands a sacrifice of empathy. When empathy is driven out, people become numbers, names lose their musicality and helpless old men get left in toilets. 
After making it through his five hour wait, the young man with heart problems is told it will take another two hours before a doctor can see him. He exits the hospital, leaving the waiting room and all its horrors behind. He would rather go home and die in his sleep than spend another moment in this waking nightmare.   
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